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One-Stage Reconstruction of a Large Perioral-Cheek Defect Using a Modified Submandibular Angle Rotation Flap.

Chao Lian¹, Xiao-Jun Liu², Xuan-Fen Zhang¹

¹Department of Plastic Surgery, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, Gansu, China.

The Journal of Craniofacial Surgery

|November 17, 2025

Summary

This summary is machine-generated.

A modified submandibular angle rotation flap offers a new solution for reconstructing large perioral defects. This technique improves aesthetic outcomes and reduces complications compared to the traditional Schrudde flap.

Keywords:

Modified submandibular angle rotation flap Schrudde angle rotation flap one-stage reconstruction perioral defect

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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible

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Published on: January 28, 2020

Area of Science:

Plastic Surgery
Reconstructive Surgery
Facial Anatomy

Background:

Reconstructing large perioral defects presents significant functional and aesthetic challenges.
Existing methods like the Schrudde angle rotation flap may lead to complications such as scar distortion and increased tension.
A need exists for improved techniques that ensure stable closure while preserving facial symmetry and lip mobility.

Purpose of the Study:

To introduce and evaluate a modified submandibular angle rotation flap for perioral defect reconstruction.
To assess the functional and aesthetic outcomes of this novel surgical technique.
To compare the modified flap's efficacy against the traditional Schrudde flap.

Main Methods:

A horizontally mirrored and oppositely rotated submandibular angle rotation flap was designed with an incision below the mandibular margin.
The technique was applied in a single-stage reconstruction following excision of a large perioral-cheek scar in a 19-year-old male.
The reconstruction was augmented with postauricular cervical Z-plasty.

Main Results:

Excellent 1-year outcomes were achieved in the single-stage reconstruction of a 5.6×4.8 cm perioral-cheek defect.
The patient demonstrated preserved oral competence, symmetric labial commissures, and a mouth opening of ≥35 mm.
The modified flap technique resulted in reduced tension and a concealed scar, avoiding commissure distortion.

Conclusions:

The modified submandibular angle rotation flap is a practical and aesthetically advantageous alternative for perioral defect reconstruction.
This technique effectively addresses the limitations of the Schrudde flap, offering improved functional and cosmetic results.
Further clinical investigation is warranted to validate the long-term efficacy and broader applicability of this modified flap.